When Contact Lenses Cause Vision Problems

Sometimes it’s easy to forget you’re even wearing contact lenses, and that’s kind of the point. Unlike eyeglasses, contact lenses are invisible, weightless and out of your way. However, contact lenses can cause complications you…

Sometimes it’s easy to forget you’re even wearing contact lenses, and that’s kind of the point. Unlike eyeglasses, contact lenses are invisible, weightless and out of your way.

However, contact lenses can cause complications you wouldn’t get from wearing glasses. When your eyes become red and inflamed from a lens-related infection, or you suffer searing pain from a scratch to the cornea — the transparent, dome-shaped outer layer of your eye — those are symptoms you can’t ignore.

Below, eye specialists describe symptoms of common contact problems such as infections and abrasions, how to stay on top of contact lens care and when it’s a good idea to take a contact lens holiday.

Seasonal allergies and contact lenses don’t get along. Exposure to mold spores, or pollens from grass or weeds, is particularly bad at this time of year, says Dr. Charlotte Joslin, an associate professor of ophthalmology with the University of Illinois College of Medicine. When combined with contacts, allergies can lead to eye irritation. In some cases, contact wearers are allergic to the lens material itself, or to protein deposits on the lenses.

Your eyes need to breathe, so to speak. Inadequately fitting contact lenses or lenses made of older-generation materials may not allow enough oxygen to the eye, Joslin says. Fortunately, materials that are much more oxygen-permeable are used for newer lenses, she says.

Avoiding Over-Wear

When symptoms appear, see an eye specialist right away, says Dr. Ryan Jaber, an ophthalmologistspecializing in corneas with the Henry Ford Health System in Detroit. Redness of the eye, blurry vision, eye pain, tears or discharge and light sensitivity are symptoms of a possible corneal abrasion or infection complication. Or it may just feel like you have something in your eye.

“If someone looks in the mirror and sees a white spot on their cornea, or anything like that, these are definitely grounds to be looked at,” Jaber says. Earlier is better for evaluating and treating eye inflammation and possible infection.

Remove your contacts and let your eye doctor know as soon as possible if you experience any of these symptoms. He or she may prescribe antibiotic eyedrops or ointment. In some cases, steroids may also be needed.

“We see a lot of signs of overwear: the eyes not getting enough oxygen from people just wearing contact lenses too much,” Jaber says. “Overnight wear is definitely the No. 1 most common way people are overusing them.” He advises against sleeping with contact lenses, even extended-wear lenses. In addition, he says, “Just using them every waking moment can be a source of overwear.”

When contact lenses don’t fit well, that contributes to overwear issues, Jaber says. A proper match is needed between the eye and the lens.

Corneal Abrasions

A corneal abrasion is a scratch on the surface of your eye. “It can happen because, maybe, the lens fit isn’t as adequate,” Joslin says. “Maybe it’s a scratch as people are removing the lens. Maybe they get a fingernail in their eye.” Scratches can happen with or without contact lenses, she points out.

“Abrasions can be incredibly painful: a 9-out-of-10 pain,” Joslin says. “The nerves are open right there and it’s very uncomfortable.” In some cases, a corneal abrasion can lead to an infection.

Keratitis, or infection of the cornea, is another possible complication from wearing contact lenses, and it can be serious. Scarring from an advanced corneal infection can threaten your vision. Infections can arise from bacteria, viruses, fungi or protozoa (microscopic parasites).

Keeping lenses in your eyes too long or sleeping in lenses may lead to infection. Hygiene issues — not cleaning lenses, not cleaning cases or topping off lens solution — are major reasons for infections.

A rare but potentially blinding eye infection called Acanthamoeba keratitis mostly occurs among contact lens wearers, who account for 85 percent of U.S. cases, according to the Centers for Disease Control and Prevention. For context, the overall incidence is only about one to two cases per 1 million contact users.

Infection risk is higher among people who improperly disinfect their lenses, such as using homemade solutions or tap water for cleaning, according to the CDC. Swimming, using a hot tub and showering while wearing lenses, as well as having any corneal damage or trauma, raise the risk of infections from contacts.

Contact Care: Do’s and Don’ts

Contact lens wearers can help protect themselves from corneal infections. “Using good hygiene is probably the most important factor,” Joslin says. “A large number of complications, particularly microbial complications — which are the most significant and devastating — can be avoided by simply improving hygiene.”

— Remember to take care of your contact lens case and replace as needed. “A lot of people continue to use the same lens case — and it looks like the bottom of a dog’s bowl,” Joslin notes. “All of that can be transferred to the eye.” If anything, she says, it’s amazing that more infections don’t arise from the various organisms that can grow out of a dirty lens case.

— Stick to treatment recommendations. That includes avoiding the temptation to stretch the life of your contacts past the prescription duration, for instance going beyond 30 days for one-month contact lenses. Dispose of lenses on time.

— Take a break from contact lenses at night. During the day, periodically give contacts a rest and wear glasses instead.

— Avoid swimming or showering with lenses. Although many wearers do keep lenses in without incident, Joslin says, “The challenge is we’re unable to identify when people are going to run into trouble.”

— When applying eye makeup, put your lenses in first, Joslin recommends. At the end of the day, take lenses out first, then remove eye makeup.

— Yearly eye exams help ensure that your eyes are healthy and your contact lens prescription stays up to date.

Colored contact lenses approved by the Food and Drug Administration and prescribed by your doctor are fine, Joslin says. However, non-FDA-approved decorative lenses are dangerous. At her university setting, she says, wearers “can really run into huge problems in terms of infections.” Unknown materials, even automobile paint, might be used in unregulated decorative lenses, she adds. Putting something like this in your eye can have extremely serious effects on your cornea, she warns.

Always have a good pair of glasses as a backup, Jaber suggests. That way, he says, when problems occur, “you don’t have to worry about powering through with contact lenses.”

Many people naturally become more intolerant of contacts over time, Jaber notes. “They’ve had really good hygiene; they don’t wear them that much,” he says. “It’s just because, as you get older, dryness is more common. It’s just more common not to be quite comfortable in contacts. It’s not necessarily a sign you’re doing something wrong.”